The association between timed up and go test and history of falls: the Tromsø study

Gyrd Thrane, Ragnar M Joakimsen, Eline Thornquist, Gyrd Thrane, Ragnar M Joakimsen, Eline Thornquist

Abstract

Background: Fall-related injuries in older adults are a major health problem. Although the aetiology of falls is multifactorial, physical factors are assumed to contribute significantly. The "Timed up and go test" (TUG) is designed to measure basic mobility function. This report evaluates the association between TUG times and history of falls.

Methods: A retrospective, observational, population-based study was conducted on 414 men and 560 women with mean age 77.5 (SD 2.3). TUG time and falls during the previous 12 months were recorded. Covariates were age, sex, medical history and health-related mobility problems. Means, confidence intervals and test characteristics for TUG were calculated. Odds ratios and influence of covariates were examined by logistic regression.

Results: The mean TUG time was 11.1s (SD 2.5) among male non-fallers and 13.0s (SD 7.8) among fallers. The difference was 1.9s (95%CI 0.9-3.0). The odds ratio for fallers being in the upper quartile was 2.1 (95%CI 1.4-3.3). Adjusted for covariates, the odds ratio was (OR = 1.8, 95%CI 1.1-2.9). The corresponding mean was 13.0s (SD 5.74) among female non-fallers and 13.9s (SD 8.5) among fallers. The difference was 0.9 (95%CI -0.3-2.1). The odds ratio for fallers being in upper quartile was 1.0 (95%CI 0.7-1.4). The area under the ROC curve was 0.50 (95%CI 0.45-0.55) in women and 0.56 (95%CI 0.50-0.62) in men.

Conclusion: TUG is statistically associated with a history of falls in men but not in women. The ability to classify fallers is poor, and the clinical value of the association is therefore limited.

Figures

Figure 1
Figure 1
Study population.

References

    1. Berg WP, Alessio HM, Mills EM, Tong C. Circumstances and consequences of falls in independent community-dwelling older adults. Age Ageing. 1997;26:261–268. doi: 10.1093/ageing/26.4.261.
    1. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–1707.
    1. Cesari M, Landi F, Torre S, Onder G, Lattanzio F, Bernabei R. Prevalence and risk factors for falls in an older community-dwelling population. J Gerontol A Biol Sci Med Sci. 2002;57:M722–M726.
    1. American Geriatrics Society; British Geriatrics Society; American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49:664–672. doi: 10.1046/j.1532-5415.2001.49115.x.
    1. Gillespie LD, Gillespie WJ, Cumming R, Lamb SE, Rowe BH. Interventions for preventing falls in the elderly. Cochrane Database Syst Rev. 2000:CD000340.
    1. Bueno-Cavanillas A, Padilla-Ruiz F, Jimenez-Moleon JJ, Peinado-Alonso CA, Galvez-Vargas R. Risk factors in falls among the elderly according to extrinsic and intrinsic precipitating causes. Eur J Epidemiol. 2000;16:849–859. doi: 10.1023/A:1007636531965.
    1. Dargent-Molina P, Douchin MN, Cormier C, Meunier PJ, Breart G. Use of clinical risk factors in elderly women with low bone mineral density to identify women at higher risk of hip fracture: The EPIDOS prospective study. Osteoporos Int. 2002;13:593–599. doi: 10.1007/s001980200078.
    1. Nevitt MC, Cummings SR, Kidd S, Black D. Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA. 1989;261:2663–2668. doi: 10.1001/jama.261.18.2663.
    1. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–148.
    1. Schoppen T, Boonstra A, Groothoff JW, de Vries J, Goeken LN, Eisma WH. The Timed "up and go" test: reliability and validity in persons with unilateral lower limb amputation. Arch Phys Med Rehabil. 1999;80:825–828. doi: 10.1016/S0003-9993(99)90234-4.
    1. Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002;82:128–137.
    1. Rockwood K, Awalt E, Carver D, MacKnight C. Feasibility and measurement properties of the functional reach and the timed up and go tests in the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci. 2000;55:M70–M73.
    1. Morris S, Morris ME, Iansek R. Reliability of measurements obtained with the Timed "Up & Go" test in people with Parkinson disease. Phys Ther. 2001;81:810–818.
    1. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896–903.
    1. Salgado R, Lord SR, Packer J, Ehrlich F. Factors associated with falling in elderly hospital patients. Gerontology. 1994;40:325–331.
    1. Gunter KB, White KN, Hayes WC, Snow CM. Functional mobility discriminates nonfallers from one-time and frequent fallers. J Gerontol A Biol Sci Med Sci. 2000;55:M672–M676.
    1. O'Brien K, Culham E, Pickles B. Balance and skeletal alignment in a group of elderly female fallers and nonfallers. J Gerontol A Biol Sci Med Sci. 1997;52:B221–B226.
    1. NICE . Clinical practice guideline for the assesment and prevention of falls in older people. National Institute of Clinical Excellence; 2004.
    1. Close JC, Lord SL, Menz HB, Sherrington C. What is the role of falls? Best Pract Res Clin Rheumatol. 2005;19:913–935. doi: 10.1016/j.berh.2005.06.002.
    1. Shumway-Cook A, Wallacott MH. Motor control Theory and Practical Applications. Second Edition. Philadelphia, Lippincott Williams & Wilkins; 2001.
    1. Newton RA. Balance screening of an inner city older adult population. Arch Phys Med Rehabil. 1997;78:587–591. doi: 10.1016/S0003-9993(97)90423-8.
    1. Lach HW, Reed AT, Arfken CL, Miller JP, Paige GD, Birge SJ, Peck WA. Falls in the elderly: reliability of a classification system. J Am Geriatr Soc. 1991;39:197–202.
    1. Cummings SR, Nevitt MC, Kidd S. Forgetting falls. The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc. 1988;36:613–616.
    1. Helse, sosiale forhold og kriminalitet. Statistics Norway; 2002.
    1. Hanninen T, Hallikainen M, Tuomainen S, Vanhanen M, Soininen H. Prevalence of mild cognitive impairment: a population-based study in elderly subjects. Acta Neurol Scand. 2002;106:148–154. doi: 10.1034/j.1600-0404.2002.01225.x.
    1. Zanetti M, Ballabio C, Abbate C, Cutaia C, Vergani C, Bergamaschini L. Mild cognitive impairment subtypes and vascular dementia in community-dwelling elderly people: a 3-year follow-up study. J Am Geriatr Soc. 2006;54:580–586. doi: 10.1111/j.1532-5415.2006.00658.x.
    1. Lin MR, Hwang HF, Hu MH, Wu HD, Wang YW, Huang FC. Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. J Am Geriatr Soc. 2004;52:1343–1348. doi: 10.1111/j.1532-5415.2004.52366.x.
    1. Bergland A, Jarnlo GB, Laake K. Predictors of falls in the elderly by location. Aging Clin Exp Res. 2003;15:43–50.

Source: PubMed

3
Subscribe